Beyond voluntary promises, standards and a federal mandate for FHIR-based APIs create a powerful framework for real prior authorization reform and broader interoperability. The recent voluntary pledge ...

Many health systems and patients have struggled with prior authorization procedures. Prior authorization practices are staying in the spotlight. Health systems are looking for payers to do more to ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

Major health insurers in the U.S. pledged Monday to overhaul the prior authorization process. Prior authorization means insurers require approval before they’ll cover medical care, a prescription or a ...

Humana has announced several steps it will take to ease prior authorization requirements. The insurer said Tuesday that by the start of next year, it will have fully eliminated about a third of prior ...

Prior authorization (PA) is a widely used insurance mechanism intended to ensure cost-effective, evidence-based care. However, in practice, it often imposes significant administrative and clinical ...